Kristin Forman, C.O.T.A.

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OP003620L Issued in PA

Practice address

Liberty Court
1560 Lombard Street
Philadelphia, PA 19146

Phone

(215) 546-5960

NPI assigned

Apr 19, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306063789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 YALE SQ",
            "city": "MORTON",
            "state": "PA",
            "postal_code": "190701925",
            "telephone_number": "610-604-9878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LIBERTY COURT",
            "address_2": "1560 LOMBARD STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19146",
            "telephone_number": "215-546-5960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "KRISTIN",
        "name_prefix": "Ms.",
        "credential": "C.O.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "PA",
            "license": "OP003620L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan Robert Forman, M.D.
• Alyson Forman, DMD
• Andrea Dawn Forman, M.S., C.G.C.
• Evan M Forman, PH.D.
• Harvey Richard Forman, M.D.
• Marc A. Forman, M.D.
• Mark S Forman, MD
• Matthew Robert Forman, PHARMD
• Scott Ian Forman, DO
• Fernanda Ann Formel

• Occupational Therapy Assistant in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Occupational Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.